Takahashi Noriyoshi, Umezawa Rei, Yamamoto Takaya, Takeda Kazuya, Suzuki Yu, Kishida Keita, Omata So, Sato Yuta, Harada Hinako, Seki Yasuhiro, Jingu Keiichi
Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Gastrointest Tumors. 2024 May 8;10(1):57-66. doi: 10.1159/000539173. eCollection 2023 Jan-Dec.
Patients with esophageal cancer who are in a poor general condition receive radiotherapy alone, but outcomes are often unsatisfactory. The aim of this study was to clarify recent outcomes of radiotherapy alone for esophageal cancer.
Patients who underwent 50 Gy or more of radiotherapy without chemotherapy were retrospectively reviewed. Endpoints were overall survival (OS), disease-specific survival (DSS), local control (LC), and progression-free survival (PFS). Survival curves were drawn using the Kaplan-Meier method, and predictors were analyzed using the Cox proportional hazards model.
Sixty-nine patients were included. The median follow-up period was 17.9 months. The 5-year OS, DSS, LC, and PFS rates were 33.2%, 49.8%, 46.2%, and 16.8%, respectively. In the multivariate Cox proportional hazard model, clinical stage was a significant predictor for OS (hazard ratio [HR]: 4.42, 95% confidence interval [CI]: 1.80-11.17, = 0.001), DSS (HR: 2.08, 95% CI: 1.43-3.12, = 0.0001), LC (HR: 1.86, 95% CI: 1.28-2.74, = 0.001), and PFS (HR: 1.65, 95% CI: 1.25-2.18, = 0.0004). Radiation dose was a significant predictor for LC (HR: 0.87, 95% CI: 0.78-0.97, = 0.018) and tumor location was a significant predictor for PFS (HR: 1.55, 95% CI: 1.10-2.19, = 0.018). In subgroup analysis, the 5-year OS, DSS, LC, and PFS rates for stage I were 60.0%, 80.0%, 71.9%, and 46.1%, respectively.
Stage, radiation dose, and tumor location are significant predictors for outcomes. Patients with stage I esophageal cancer can be cured by radiotherapy alone.
一般状况较差的食管癌患者接受单纯放疗，但结果往往不尽人意。本研究旨在阐明食管癌单纯放疗的近期疗效。
回顾性分析未接受化疗、接受50 Gy或更高剂量放疗的患者。观察终点为总生存期（OS）、疾病特异性生存期（DSS）、局部控制率（LC）和无进展生存期（PFS）。采用Kaplan-Meier法绘制生存曲线，并使用Cox比例风险模型分析预测因素。
纳入69例患者。中位随访期为17.9个月。5年总生存期、疾病特异性生存期、局部控制率和无进展生存期分别为33.2%、49.8%、46.2%和16.8%。在多因素Cox比例风险模型中，临床分期是总生存期（风险比[HR]：4.42，95%置信区间[CI]：1.80 - 11.17，P = 0.001）、疾病特异性生存期（HR：2.08，95% CI：1.43 - 3.12，P = 0.0001）、局部控制率（HR：1.86, 95% CI：1.28 - 2.74，P = 0.001）和无进展生存期（HR：1.65，95% CI：1.25 - 2.18，P = 0.0004）的显著预测因素。放疗剂量是局部控制率的显著预测因素（HR：0.87，95% CI：）。在亚组分析中，Ⅰ期患者的5年总生存期、疾病特异性生存期、局部控制率和无进展生存期分别为60.0%、80.0%、71.9%和46.1%。
分期、放疗剂量和肿瘤位置是疗效显著的预测因素。Ⅰ期食管癌患者可通过单纯放疗治愈。 （原文中放疗剂量95%CI区间未完整给出，翻译时保留原文格式）
